Should sex change operations be stopped?

1 August, 2007

While driving home tonight I was listening to BBC Radio 4, at 8pm there started a programme called “Hecklers“. It’s a debating show. The format of the show is this, one person airs their view (usually very controversial) in front of a panel of 4 opposing experts.

When I heard the topic announced, the hair on the back of my neck stood up! I kept listening. Here’s a transcript of her three minute opening argument;

“My proposition, that sex change surgery should not be available and that the psychiatric diagnosis of Transexualism is questionable, might lead some in the audience to jump to the conclusion that I’m some kind of ultra conservative; the kind of person who’d argue that homosexuality should be against the law. In fact nothing could be further from the truth. As a life long feminist and defender of human rights and the abused and the oppressed; I refute that claim, and it’s because of, not inspite of my commitment to equal rights and the acceptance of those who are just different, that I’m so vehamently opposed to the growing use of sex change surgery. Indeed I suspect one day we’ll look back on the current era of sex change surgery with the same horror as we look back on the days of aversion therapy treatment for homosexuals. The parallels are striking. In the 1950s, a medical profession, dominated by ultra traditional men, told us that homosexuality was a psychiatric condition which they could cure. Those that didn’t fit their stereotypes or their model of gender polarisation could be made to fit with the help of doctors. The treatment was traumatic and it didn’t work and the patients weren’t ill they were just different. The same goes for the so called diagnosis of Transexualism or Gender Identity Disphoria as it’s now known.

A man who says he feels disengaged from the masculine norm isn’t ill, he just doesn’t fit societies expectations of what is a real man. The concept of Transexuality arises from the strong stereotyping of boys and girls; men and women, would it exist if we lived in a world where the attitude to gender and sexuality was relaxed, was live and let live. How could psychiatrists confirm a patients self diagnosis of Transexualism by asking if he played with dolls and make-up. If these behaviours were not forced upon children in the first place. Feminists and sections of the gay and lesbian liberation movement have for the past four decades lived outside of the gender roles prescribed to us by the traditionalists. The Transgender industry and its spokes people are the defenders of gender. In fact they are running a gender protection racket. If you doubt me when I say those involved in the Transgender industry are the ultra conservatives, just take a vist to one of the shops that cater for Transgender people, or look on their websites. One website aimed at Transexuals offers tips for men wishing to pass as women. This is what it says “Repeat constantly to yourself, raising your voice at least one octave “Am I going shopping today?”, “Could you tell me the time please?”, “Can I try this blouse on please?””

The clothes and behaviour patterns often rejected by modern women are seen as the key part of successful gender reassignment, one hormone cream even claims to enable men to feel the symptoms of premenstrual tension. Feminists who question the ethics of sex change surgery are the true progressives and those offered butchery to correct psychological distress; the victims.”

There followed thirty minutes of poor old Julie defending herself against 1 gay human rights activist, 2 post op Transpeople and 1 surgeon who performs gender reassignment operations. I could personally see Julies point that it’s society who set the yardsticks for those people who say they are in the wrong bodies, why do we think it’s a medical condition? Annorexics look at themselves in the mirror and think they’re fat, should they be given extensive liposuction so that they can feel comfortable in their own skins? Ok maybe that’s a simplistic argument, but where is it written that men and women have to conform to specific gender stereotypes. What is a true male charateristic? Where do these characteristics come from? Are they abstract concepts like law and justice that we, as a society, have made up, or are they real physiological biological functions that are ingrained in our DNA? Is there a gene for wanting to wear lipstick and high heels? Is there a gene for playing with car engines and watching football? I seriously doubt it.

The more the general population see diverse images of every kind of person in ordinary situations, the quicker they’ll get used to the idea that no two people are the same and that we all can’t be neatly pidgeon holed into pre defined sexualities or genders. We are who we are and Vive La Difference!

FOOTNOTE: If you would like a copy of the full radio programme in which this was discussed, please email me or leave a comment on this post. You will need to have or download RealPlayer to be able to listen to it.

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It’s also refreshing to come across someone on the internet who understands that people are different from one another… it’s a soundbite that’s thrown around, but people don’t seem to understand it at all.

(I’m gender-fluid, by the way. I feel male, but don’t fit into male gender roles at all… so I doubt I’d ever “transition” as life would be far worse then).

For example, I regularly read bmezine.com – a site where people document their experiences of changing their bodies – from nose rings to tattoos to transpeople to voluntary eunuchs. I find it compelling to read about other people’s motivations and interests – but the amount of abuse its enthusiasts get is frightening.

Why? One man undergoing castration doesn’t affect the testicles of another, random man. One lady with a nose ring doesn’t affect anyone else’s nose. One man having consensual gay sex doesn’t do anything to a straight man’s ass… An inability to grasp that someone can be mentally healthy while still being different from oneself is something that humans find hard to grasp.

I guess that more insecure people feel they need vindication – a full transperson might feel threatened by the existence of the happily gender-fluid, because he or she tried so hard. And someone who has probably spent decades being bullied about gender norms probably has a right to feel insecure.

Mike, I too yearn for the day when people can just be themselves without fear or condemnation. But for some of us, being ourselves requires medical intervention. Like mark, I am also a transsexual man.

Julie’s assertion that transsexualism reinforces gender sterotyping reflects a fear and misunderstanding that seems to be rather widespread in the feminist community. For us, acceptence from society isn’t enough. Those who appear as women are treated like women. Those who appear as men are treated like men. It’s not that either is better than the other: both have pros and cons. But when one’s internal identity is male, and everywhere he goes, others treat him like a lady, little if any authentic social interaction can occur.

As Mark pointed out, there’s also the mirror– Painful to look into when you constantly think of yourself one way, and your appearance is the opposite. And of course, a pre-transition, pre-operative body creates limitations in everyday life. For us transmen, breasts. While all the other men in our lives can take off their shirts on a hot summer day, well, you get the picture. Not to mention the overall burden of them. And try building muscle without testosterone. Yes, I know there are female body builders, but they either got really lucky in the genetic lottery or they’re shooting steroids.

But the ultimate proof, for me, that transsexualism isn’t a social construct, is in the hormones. My brain did not run right on estrogen. I lived constantly in a fog of confusion and anxiety until the day I got my first testosterone shot. In the months since, my mind has gradually become clearer and clearer and my moods far more stable. It’s not the testosterone itself; transwomen report a similar reaction to estrogen. There definitely something physical involved. Our brains were wired for opposite sex hormones.

I am concerned that there are some old-school psychiatrists still out there pressuring transsexuals into a “one size fits all” transition. Some won’t approve any treatment unless the client expresses a wish to have genital surgery. As Mark said, we all have different needs, and we all feel differently about our body parts. We must be allowed to choose for ourselves which treatments and surgeries we want. Otherwise, we wind up with people regretting their transitions, which hurts not only them, but our entire community and the medical professionals who support us.

Oh, and thanks. It’s really refreshing to come across a decent, respectful blogger for a change. I get so tired of arguing with transphobes.

It has been my experience that the more well-adjusted trans people tend not to fit the stereotype all that well. There are many that are quite butch, in fact. The stereotype, however, has not been helped by the many years in which to be considered by the medical profession, you had to present like that to them.

Many of those who claim to actively oppose gender actually support the two discrete types viewpoint, if you look deeper into what they wish to say. Firstly, they often have an irrational dislike for those who challenge their physical sex, when indeed the concept of only two physical sexes is part of the problem and part of the reason why it is so easy to state that there is only two genders. Secondly, the fact that the most vocal group on this matter calls themselves feminists, a highly gendered word, must be at least a little amusing. Finally, and most importantly, these people have and maintain a gendered privledge, they inevitably have a gender stereotype available to hide behind on bad days. They will never admit it, but they almost certainly do not actively crusade against pronouns, and will at times take advantage of the comfort and security that having gendered privledge allows. They have no actual desire to truely break from their gendered privledge at all.

The desire for surgery should never be motivated by the need to ‘fit in’, and I would hope that if this was the reason given, the medical profession would discourage having the operation.

The comparison to annorexia is quite false and inappropriate. As I understand it, annorexia is a mental health issue regarding general body image that becomes focused upon weight. A core part of the diagnosis of annorexia is that there is no such thing as an ideal figure for those suffering from it, and they are never happy with their body. As such, simply removing fat would not solve the problem. With the treatment of gender dysphoria, however, there are two issues. Firstly, hormones are powerful things, and their positive effect on correctly diagnosed trans people does indicate a physiological need. Secondly, the process of transitioning and successfully living as a member of the desired target group should result in significant improvement in self-image. Surgery itself should never be viewed as a fix to poor self-image. We know from studies of non-trans people, however, that corrective surgery to those who have serious abnormalities or have had parts removed, does give noticeable benefits. Surgery also allows trans people to more easily and freely have relationships with those of their desired partner sexuality.

The lack of long-term followups for trans people is partially the fault of the medical profession (who rarely have actually attempted to do this), and partially relates to the stigma of being trans. It would benefit everyone for more research to be done, but radio soapboxes like this only make the stigma seem worse, and so encourage hiding more.

Ultimately, however, gender is an evil thing, and almost every trans person I know dislikes it. Living in a world were gender was much more open would be better for everyone, and it would reduce but not eliminate (as there is a physical side) the need to treat gender dysphoria. Binomial Gender really does need to be torn down, but programs like this, and the gendered fight of most feminists are not the right way to go about it.

Fascinating – I’d never thought of Julie’s argument before and I did find it very refreshing. I have always found it interesting that transsexuals (men to women) often want to dress like so-called “feminine” women – skirts and make-up etc. I feel very feminine but don’t usually dress in a traditionally “feminine” way – I occasionally wear skirts, occasionally jewellery but never make-up – because I feel feminine enough without these things.
Perhaps if society can grow to be more accepting of ALL the variations in gender and sexuality, then fewer transsexuals would feel the need for surgery – but perhaps some always would, and in my opinion both are absolutely fine. “Live and let live” and “I am what I am” are both excellent bases for living, in my opinion.

To Mark – Thank you for sharing your first person perspective. I’ve never had to confront issues of this nature, which is why I found the debate so interesting. I can honestly say I’d never really formed an opinion on Transexualism except one of “live and let live”.

While I still agree with Julie that people should be free to be who they are without society putting on pressure to conform to gender stereotypes, I can see that there is a lot more to the issue than just “lipstick and football”. Once again life throws out a curve ball to reaffirm that we cannot set everything in black and white; that there are those who live within the grey and if surgery allows those people to live comfortably in their own skin, then that’s what they must do.

Gender role and gender identity are quite different. Wanting to wear lipstick or playing with dolls falls into the role area. Identifying or seeing oneself opposite of what our bodies show is identity. As a transsexual man, I have never had the need to blend in society or feel that I need to compete with other men. I am who I am. I like myself better now than ever before. When I look in the mirror things make sense where as before it was obscured.

Transsexuality or gender identity stems from a miss communication between receptors and genes. The hormonal bathing that took place in utero went wrong, hence creating a misalignment between gender and physical sex. It is subject to a continuum or spectrum, therefore, no two transsexual will identify the same or have the same needs. Some will require surgery, while others will not. Please visit my website http://www.bodiesunderconstructiononline.com enter Mark’s Transition a page I have dedicated for education on transsexualism. I have made various videos and short documentaries, as well as provided links to scientific evidence regarding our condition.

I agree that most transsexuals want to fit nicely into the norm, but I say what is the norm. I say we each walk to a different beat of our drums, or should. To try to blend or hide will never solve any of our problems and will only continue the bigotry we see today and in the past. I say lets be proud of who we are and help educate the world that nature does have variety and does vere from it’s typical development. We are not diseased, but we are made different, and you know what that is okay.

Please view this video I put together, it is a eulogy for my old self. I was born Maritza Delcarmen Perdomo in Havana Cuba first born. My mother took hormones to try to get pregnant the hormones created the hormonal imbalance that brought upon my gender dysphoria. I want to help the world realize who we are and what we are all about, and definitely it is more than lipstick and dolls or aftershave and trucks.

I think that the point of her address was just, as you say, with the rise of the Metrosexual and the blurring of gender stereotypes, do people need to have surgery. It should be acceptable for people to be who they are without having to go to the extremes of having healthy bits of their bodies chopped off or altered. As a society we should be encouraging people to be comfortable in their own skins. She has a compelling point!

To Marti – Thanks, the info was very useful

In the UK there has not been that much research into aftercare of Transpeople, that was one of the things that came out of the debate. It appears that Transpeople disappear into the ether and are not monitored due to financial constraints. There has been no research to show how successful the medical procedures have been physically and more importantly whether the people who have undergone these procedures have adjusted mentally to the change. Ther only evidence that the “medical professionals” have to go on is anecdotal. I agree that she proposes a shift in societies beliefs of what is an acceptable gender role, what she is saying is that biological sex (how a person is born)and learned gender roles are not quite the same thing.

“What is a true male charateristic? Where do these characteristics come from? Are they abstract concepts like law and justice that we, as a society, have made up, or are they real physiological biological functions that are ingrained in our DNA? Is there a gene for wanting to wear lipstick and high heels? Is there a gene for playing with car engines and watching football? I seriously doubt it.”

While I don’t profess to understand the ins and outs of transexuality, I do think it goes a bit further than whether or not someone fits the ‘norm’.

‘Norm’ these days is ever more confusing – what with the rise of ‘metrosexual man’ – comfortable with their feminine side and the like.

I’ve always thought there was a very real medical and psychological basis for transexuality – something to to with chromosomes (I couldn’t be further away from a medical expert if I tried, but I seem to recall something about XXY chromosomes which influences who, both psychologically and physically, a person is).

While I agree that everyone should be accepted for who/what they are (one day, perhaps) – I think transexuality is a completely different thing altogether. From what I can gather I think, in this instance at least, there really is a real physiological biological function that is ingrained somewhere. Whether that’s in the DNA or not is another question.